Provider Demographics
NPI:1366540973
Name:VOHRA, SANJAY (MD)
Entity type:Individual
Prefix:
First Name:SANJAY
Middle Name:
Last Name:VOHRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8965 S PECOS RD STE 12A
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7159
Mailing Address - Country:US
Mailing Address - Phone:702-564-9898
Mailing Address - Fax:702-564-9850
Practice Address - Street 1:8965 S PECOS RD
Practice Address - Street 2:SUITE 12A
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074
Practice Address - Country:US
Practice Address - Phone:702-564-9898
Practice Address - Fax:702-564-9850
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6086207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002019698Medicaid
NVV35874Medicare ID - Type Unspecified
NV002019698Medicaid